PROGNOSTIC SIGNIFICANCE OF CLINICAL AND LABORATORY INDICATORS IN PATIENTS WITH CHRONIC HEART FAILURE

Chronic heart failure remains a progressive and ultimately fatal syndrome, representing a massive burden on the healthcare system of the Republic of Uzbekistan. This prospective observational study investigates the specific prognostic value of clinical, echocardiographic, and laboratory indicators in predicting adverse cardiovascular outcomes among patients with chronic heart failure residing in the Andijan region. A cohort of 420 patients with established chronic heart failure (NYHA functional classes II-IV) was continuously monitored over an 18-month period at regional cardiological centers. The study evaluated conventional clinical metrics alongside advanced biomarkers, specifically N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hs-CRP), and the estimated glomerular filtration rate. The empirical results demonstrated that while traditional symptoms and the six-minute walk test provided foundational functional data, they lacked sufficient sensitivity for predicting imminent decompensation. Conversely, elevated baseline NT-proBNP levels (exceeding 1200 pg/mL), reduced left ventricular ejection fraction (below 35%), and the presence of subclinical renal dysfunction emerged as the most potent, independent predictors of hospital readmission and cardiovascular mortality. The discussion contextualizes these findings within the local epidemiological landscape of the Fergana Valley, emphasizing issues such as medication adherence and the late clinical presentation of ischemic heart disease. The study concludes that the routine integration of molecular biomarkers, specifically NT-proBNP, into standard regional cardiological protocols is imperative for accurately stratifying risk, optimizing guideline-directed medical therapy, and ultimately reducing the high rates of re-hospitalization among the vulnerable heart failure population in Andijan.